ATI RN COMPREHENSIVE EXIT EXAM, latest version{Download to get an A}All answers verified

ATI RN COMPREHENSIVE EXIT EXAM diet for chronic renal failureans: low protein & potassium DM pt teachingans: change shoes, wash bfeet w/soap & water pulse pressureans: subtract systolic value from diastolic value lantusans: never mix, long lasting, no peak rhogamans: given @ 28 weeks & 72 hours post delivery when mom is negative & baby positive indication of baby dehydration improvingans: smooth fontannel pt w/orthostatic hypotensionans: put near nursing station cleaning a woundans: clean to dirty use bulb syringe peripheral arterial diseaseans: cramp in leg while walking intermitment claudication seizure precautionsans: supine position 20 weeks gestation, having urinary frequencyans: u/a & c/s report to new nurse @ shift changeans: pt @ xray s/s of hemolytic blood transfusionans: flank pain ER rape victim priorityans: acess anxiety nutritionans: carbs 45%, protein 10-15% latex allergyans: tape up cords first ingredient on a food labelans: most content thoracentesis, & painful w/breathingans: put pt on UNAFFECTED side for 1 hour or longer pt w/IV sedationans: check LOC if not responsive help older brother get used to babyans: get a gift for big brother early decelerationsans: head compressions methergine contraindicationans: HTN delegate to APans: I & O HF monitoringans: weights location for peripheral lineans: radial prioritizing care for multiple pt'sans: low flank pain ativanans: for seizures med for diabetes insipidusans: desmopressin radiation tatooans: use mild soap & water uric acid stonesans: eat low fat yogurt antigout med decreases uric acid levelans: allopurinol non-pharm relation technique for pain management in laborans: hypnosis psychotic disorder assessment findingans: flat affect newborn withdrawal from heroin (opioids)ans: hypertonicity mitral valve locationans: 5th intercostal amniocentesisans: go pee before procedure total gastrectomyans: lack b 12 takes 30-60 meal to eat a meal stoma colorans: pink or red is normal MAOI's dietans: no pepperoni, no tyramine, COTTAGE CHEESE OKJ give iron w/?ans: OJ statins contraindicationans: Grapefruit juice haldolans: lip smacking mag sulfateans: decreased urine output decreased respirations decreased pulmonary edema antidote for mag sulfateans: calcium gluconate clozaril interventionsans: monitor WBC valproic acidans: liver function thyroid med effectivenessans: weight loss diureticsans: don't skip doses DIG adverse effectsans: N/V & HA prednisoneans: take with milk hemo/peritoneal dialysis pt teachingans: medical asepsis cranial nerve 11ans: shoulder peripheral catheter insertionans: advance catheter when you see flash back of blood return dispose of insulin needles @ homeans: in coffee container confirmation of ng placementans: x ray swallowing difficulty referralans: speech therapy acraboseans: skip a meal, skip dose, give w/1st bite of food sprains & strainsans: RICE pt DNR-CC & family asking questions related to. therapeutic communication: THERAPEUTIC RESPONSEans: What did the dr tell you? delegating to AP about skeletal traction: NEEDS MORE TEACHINGans: AP places weight on bed daughter feeling guilty about admitting parent into long-term facility: THERAPEUTIC RESPONSEans: rephrase what daughter is feeling how good nurse plans her dayans: rechecks her priorities half way through her shift good nurse sets these when she worksans: GOALS pt gets bad dx, & asks you not to tell her spouse:YOUR RESPONSEans: you have a right to privacy delegate to APans: CPR baby in contact precautions in a private room, what would you do to save hospital $?ans: bring formula prn how does a nurse properly manage her time mid-shift?ans: reevaluates goals which psych pt would you see first?ans: hallucinations dementia pt @ ER, w/marks on coccyx & wrist, suspected abuse. what do you do?ans: ask pt. INTERVIEW HIM psych pt yelling in front of group. very agitated, what do you do?ans: isolate pt charge nurse scheduling resolution between nursesans: nurse listens to both sides respite careans: gives family a break pt in seclusion documentationans: what happened prior to seclusion that caused for seclusion parkinson's : pt teachingans: nutrition- thicken liquids pt receiving radiation, what should you wear?ans: lead apron pt suffering from hyperthermiaans: seizure precautions pt refuses last minute for a procedure he already consented forans: okay to stop procedure s/s of smallpoxans: rash on tongue xerostomaans: humidifier vagina procedure, cervical cancerans: place catheter Lyme diseaseans: report it lice (pediculodis capitis)ans: can survive on surfaces for up to 48 hours RSVans: keep stethescope in room (droplet) 16 weeks gestationans: can get AFP test done bacterial meningitisans: droplet precautions when can kid return to school for chicken poxans: when lesions are crusted over kicks a ball: developmental stageans: 24 months baby w/cleft lipans: untie arms & perform ROM wrong ostomy careans: changing everyday may lead to skin irritation after male circumcisionans: apply petroleum jelly w/every diaper change breastfeeding w/hep cans: don't breast feed if you have cracked nipples contraindication w/oral contraceptivesans: HTN combination contraceptives contraindicationsans: pt w/migraines when percussing RUQ, what should we feelans: dullness dementia ptans: offer finger foods black males @ great risk forans: CVA med for alcohol withdrawalans: disulfiran (antabuse) better nutririonans: canola oil healthy eatingans: 45 % carbs to prevent neuro tube defectsans: folate prevnting delays of healingans: protein & o2 pt raped & @ ERans: assess anxiety pt reports abuseans: assess pt, check for injuries anorexiaans: 60% refeeding-pre-albumin of 10 telemetry is used forans: check for dysrythmia do not give mmrans: to child bearing pt b4 pregnancy test pt w/hx of blood transfusion diet for hfans: dry spices to flavor food TURP: closed intrermittment irrigationans: let it drain Cranial nerve XIans: (hot spot) shoulder Proper lifting techniqueans: (picture) bending at knees 24 month oldans: walk up steps Food labelans: greatest weight listed first IV techniqueans: advance catheter Refeeding syndromeans: 60% Low fat dietans: canola oil instead of vegetable oil Prior to amniocentesisans: empty bladder Radiation implantans: limit visitors to 30 minutes Levothyroxineans: take on empty stomach, in am; increases tsh Metformin contraindicationans: kidney disease, severe infection, shock, hypoxic conditions Mastectomyans: lay of affected side to promote drainage, support arm on pillow, HOB 30 Circumcisionans: use petroleum jelly with every diaper change Check for NG tube placement in the jejunumans: X-ray Colostomy careans: cut the bag Seizure precautionsans: saline lock IV Ethical medical errorans: veracity Early decelerationsans: head compressions Magnesium sulfate interventionsans: (select all) calcium gluconate, stop infusion, UO less than 30, RR less than 12, decreased reflexes Thoracentesis causes pneumothorax expected findingans: not friction rub; tracheal deviation AP's talking in cafeteriaans: tell them to stop talking Safety for parkinson'sans: clear area Warfarinans: vitamin k for toxicity; INR 2-3; PT 11-12.5 Contraindication of MMRans: blood transfusion Diabetic foot careans: (select all) change shoes frequently, wash feet with soap and water Sprainsans: avoid warm compress Expected finding of small poxans: rash in mouth 16 weeks pregnantans: alpha protein Psych medans: lip smacking Where to start IV firstans: (picture) hand PRBC need further teachingans: start IV on other arm Delegate to APans: CPR compressions Delegate to LPNans: sterile dressing Postural drainageans: give albuterol, trendelenberg; 1 hour before meals or 2 hours after Dumping syndromeans: high protein and fat; avoid milk, sweets, and sugar; small, frequent meals DASH dietans: increase fruit, vegetables, and low fat dairy; k, mg, ca Baby with refluxans: small, frequent meals, thicken formula with rice cereal, HOB 30 Cleft palate repairans: periodic restraints Nephrotic syndromeans: vitamin K Pernicious anemiaans: schilling's test Peritoneal dialysisans: report cloudy; monitor glucose; warm solution before Gastric surgeryans: eat 3 meals Gastrectomyans: small, frequent meals; vitamin B12, D, iron, and folate Statinans: grapefruit Preventing uric acid stonesans: yogurt RSVans: have own stethoscope in room Change of shift reportans: orthostatic hypotension by nurses station Confused patientans: raise 1 side rail Hypoglycemiaans: cool and clammy skin Hyperglycemiaans: thirst Glycosylated blood testans: HbA1C Priority for patient in seclusionans: document Buddhist patientans: vegetarian Positive TBans: hard raised bump Heart murmur soundans: blowing or swishing Dehydrationans: oliguria NSTans: PADans: pain/cramping when walking, calf muscle atrophy, shiny cool extremities; elevate legs Cast with white extremityans: compartment syndrome Alcohol withdrawal expected findingans: n&v, tachycardia, diaphoresis, tremors, seizures Varicellaans: scabs okay Hyperthermiaans: not blanket or ice Purpose of iceans: decrease inflammation Sexual assaultans: assess anxiety THAans: avoid flexion greater than 90 Beta blocker teachingans: don't stop abruptly; avoid in asthma; take with food Combination contraceptivesans: increase BP Myelosuppressionans: flu shot Glucocorticoidans: increase dose in DM; take with meals; avoid NSAIDs; Addison's crisis if stopped abruptly Extreme focusans: mild anxiety Good dietans: 30% carbs Family concernans: what has the doctor told you Adolescentans: 1300 mg of calcium Lyme diseaseans: report to health department Organize workloadans: goals for the day Interveneans: pacing around wife Renal failureans: decrease protein, K, Na, increase carbs, strict I&O Preeclampsiaans: proteinuria Urine frequency in pregnancyans: urine sensitivity test Liceans: can live for 48 hours on surfaces Chest tube complicationsans: bubbling in water seal Elderly abuseans: ask privately Informed consentans: signed willingly Sibling bondingans: offer gift each time sibling gets one TURP complicationans: hematuria African american over Caucasianans: heart disease Sickle cell priorityans: hydration Sickle cell complicationans: SOB Respite careans: give caretaker break Acarbuseans: take with first bite of each meal Hallucinationans: I understand you are scared Fire extinguisherans: PASS Advanced directiveans: don't need a lawyer Breastfeeding and hepatitis cans: as long as you don't have cracked nipples ICPans: keep HOB midline Long term use of proton pump inhibitorsans: osteoporosis Diabetes insipidusans: polyuria Difficulty voidingans: warm water ACE inhibitorsans: cough What do you hear when you palpate abdomenans: resonance Negotiation strategyans: understand both sides Dying patient wants to be aloneans: depression or dysfunctional Wife progressing quicklyans: can you tell me more Pregnant non-pharmacological pain managementans: aromatherapy, breathing techniques, imagery, music, use of focal points, subdued lighting Hypnosis purposeans: alter perception of pain Complication of conscious sedation with RR 6ans: stop infusion or give something Major depression, OCDans: give fluoxetine What causes constipationans: iron Patient can't sleepans: don't drink caffeine before bed Collecting urine culture on babyans: straight cath Electrolytesans: Na - 136-145 K - 3.5-5 Ca - 9-10.5 Mg - 1.3-2.1 P - 3-4.5 Cl - 98-106 Hypervolemiaans: bounding, JVD, edema, confusion, increase everything Anorexiaans: prealbumin 10 Dehydration improving babyans: flat fontanelle Unsaturated fatans: coconut oil Priorityans: abdominal pain and went away Opioid agonistans: naloxone (Narcan) COPDans: increase calories and protein Needle disposal at homeans: coffee container on top shelf Give RhoGAM in second pregnancyans: protect future pregnancy Swallow problemans: refer to speech therapist Nutrition for heart failureans: Decrease Na, increase fluids, increase fiber; increase K with diuretic Adverse affects of dogoxinans: Bleeding gums, bloody urine and stools, arrhythmias, petichiae NG nutritionans: Increase K Methotrexate adverse affectans: High blood pressure I.M. site for childrenans: VASTUS LATERALIS or antelolateral thigh is the site for IM injections in children 2 yrs. of age Peak Levelsans: show the highest concentration Time for drawing Peak levels: Oral Intakeans: 1 to 2 hour after administration Time for drawing Peak levels: I.M.ans: 1 hour after administration Time for drawing Peak levels: I.V.ans: 30 minutes after administration Trough Levelsans: show the lowest concentration or residual level, usually obtained within 15 minutes before next dose. Do not administer until confirmed. Can meds be administered through blood tubing?ans: NO. Never administer meds through tubing being used for blood administration How long should fluids be infused?ans: Fluids should be infused within 24 hours, discard unused potion, to prevent infection Complications associated with IV infusionans: infiltration, extravasation, phlebitis, thrombophlebitis, hematoma, venous spasm Preventing Infiltrationans: use smallest catheter for prescribed therapy, stabilize port-access, assess blood return Treatment of Infiltrationans: stop, remove, cold compress, elevate extremity, insert new cath in opposite extremity Preventing Extravasationans: know vesicant potential before giving medication Treatment of Extravasationans: stop, discontinue, aspirate med if possible, cold compress, document Preventing Phlebitis & Thrombophlebitisans: rotate sites every 72 to 96 hrs, secure catheter, aseptic technique for PICC lines, limit activity with extremity Treatment of Phlebitis & Thrombophlebitisans: stop, remove, heat compress, insert new cath in opposite extremity Preventing Hematomaans: avoid veins not easily seen or palpated, obtain hemostasis after insertion Treatment of Hematomaans: remove, apply pressure, monitor for signs of phlebitis and treat Preventing Venous Spasmans: allow time for vein diameter to return after tourniquet removed, infuse fluids at room temp Treatment of Venous Spasmans: temporarily slow infusion rate, warm compress TPNans: hypertonic solution, contains dextrose, proteins, electrolytes, minerals, trace elements, and insulin prescribed, administered via central venous device like PICC line, subclavian, or internal jugular vein Care for TPNans: verify with another nurse, use infusion pump, monitor daily weights, I & O, fluid balance, serum glucose q4 to 6 hrs, infection, change dressing q48 to 72 hrs, change tubing and fluid q24 hours, if TPN is unavailable, administer dextrose 10% in water to prevent hypoglycemia Complications of central venous cathetersans: pneumothorax during insertion, air embolism, lumen occlusion, bloodstream infection Pneumothorax during insertionans: use ultrasound to locate veins, avoid subclavian insertion when possible, treat with O2, assist with chest tube insertion Air Embolismans: have client lie flat when changing administration set or needleless connectors, ask client to perform Valsava maneuver, treat by placing client in left lateral trendelenberg, and O2 Lumen Occlusionans: flush promptly with NS between, before, and after each med, treat with 10 cc syringe with pulsing motion Bloodstream Infectionans: maintain sterile technique, treat by changing entire infusion system, notify MD, obtain cultures, and administer antibiotics Antidote for Acetaminophenans: Acetylcysteine, Mucomyst Antidote for Benzodiazepineans: Flumazenil, romazicon Antidote for Curareans: edrophonium, tensilon Antidote for Cyanide Poisoningans: methylene blue Antidote for Digitalisans: digoxin immune FAB, Digibind Antidote for ethylene poisioningans: fomepizole, antizol Antidote for Heparin and enoxaparin or Lovenoxans: Protamine Sulfate Antidote for Ironans: Deferoxamine, desferal Antidote for Magnesium Sulfateans: calcium gluconate 10%, kalcinate Antidote for Narcoticsans: naloxone, narcan Antidote for Warfarinans: phytonadione, vitamin K aminophyllineans: 10 to 20 mcg/ml carbamazepineans: 5 to 12 mcg/ml digoxinans: 0.8 to 2.0 mcg/ml gentamicinans: 0.5 to 0.8 mcg/ml lidocaineans: 1.5 to 5.0 mcg/ml lithiumans: 0.4 to 1.4 mcg/ml magnesium sulfateans: 4 to 8 mcg/ml phenobarbitalans: 10 to 30 mcg/ml phenytoinans: 10 to 20 mcg/ml quinidineans: 2 to 5 mcg/ml salicylateans: 100 to 250 mcg/ml theophyllineans: 10 to 20 mcg/ml tobramycinans: 5 to 10 mcg/ml acetaminophen toxicityans: 250 aminophylline toxicityans: 20 amitriptyline toxicityans: 500 digoxin toxicityans: 2.4 gentamicin toxicityans: 12 lidocaine toxicityans: 5 lithium toxicityans: 2.0 magnesium sulfate toxictyans: 9 methotrexate toxicityans: 10 over 24 hours phenobarbital toxicityans: 40 phenytoin toxicityans: 30 quinidine toxicityans: 10 salicylate toxicityans: 300 theophylline toxicityans: 20 tobramycin toxicityans: 12 PRILans: ace inhibitors, captopril, enalapril VIRans: antivirals, acyclovir, valacylovir AZOLEans: anti fungals, fluconazole, variconazole STATINans: antilipidemics, atorvastatin, simvastatin SARTANans: angiotensin 2 receptor blockers, ARBS, valsartan, losartan OLOLans: beta blockers, metoprolol, nadolol DIPINEans: calcium channel blockers, amlodipine, nifedipine AFILans: erectile dysfunction meds, sidenafil, tadalafil DINEans: histamine 2 receptor blockers, ranitidine, famotidine